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Octreotide in the Prevention of Intra-abdominal Complications Following Elective Pancreatic Resection—Invited Critique
John A Windsor, MBChB, MD, FRACS, FACS
Auckland, New Zealand
Arch Surg. 2004;139:295.
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Alas, another trial and still no answer. This well-conceived and well-conducted randomized trial fuels the debate and leaves us where we started. All 8 published trials examining the use of prophylactic octreotide have their differences in design and outcome, but the most compelling finding is the transatlantic discord: the European trials favor the use of octreotide, whereas the American trials do not. Because of this it is still not possible to state that administration of prophylactic octreotide is a standard of care following pancreatic resection.
The particular strengths of this French trial are that it involves multiple centers and has an all-inclusive end point: intra-abdominal complications. The weak aspects of the trial are that it is relatively underpowered (requiring subgroup analysis to reach significance), includes a potentially significant confounder (uncontrolled use of fibrin glue to duct or anastomosis), has a dubious definition of . . . [Full Text of this Article]
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Arch Surg. 2004;139(3):288-294.
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